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-. -. <br /> , � <br /> FOR OFFICE US� Op�ILY <br /> ,;- .. . . . <br /> ADDRESS <br /> (1) BUILDING PERMIT FEE $ <br /> (A) PLAN CHECK FEF <br /> (2) PLUMBING <br /> (3) MECHANICAL <br /> (4) STATE SURCNARGES <br /> (A) BUILOING CODE <br /> (B) ENFRGY CODE <br /> (5) DRIVFWAY PERMIT <br /> $ <br /> (6) WATER SERVICE TO BE PAID PRIOR TO BUILDING PERMIT ISSUANCE $ /OS <br /> (A) TO BE DETERMINED BY BLDG. INSPECTOR INCH <br /> � (B) EXI•°T. WATER SERVICE.APPLICATION NO._ <br /> i (7) STATUS OF SEWER CHARGES: <br /> i BOND DISTRICT FOOTAGE <br /> N, S, E, W <br /> I <br /> SYSTEMS DEVELOPMENT <br /> WATER �� <br /> SEWER �� <br /> TOTAL ORD. FEE /a 9� <br /> SEWER CONNECTION CHARGES <br /> YEAR TRUNK $ <br /> LATERAL <br /> TOTAL CONNECTION CHARGES $ <br /> SEWER PERMIT FEE $ �0 <br />